Cloud Providers Reaffirm Support for Healthcare Interoperability

July 31, 2019 - Microsoft, Amazon, Google, IBM, Oracle, and Salesforce reaffirmed their commitment to healthcare interoperability, particularly the HL7’s Fast Healthcare Interoperability Resources (FHIR) framework, at the Centers for Medicare and Medicaid Service (CMS) Blue Button 2.0 Developer Conference held July 30 in Washington, DC.

Healthcare interoperability is seen as a key to effective functioning of healthcare infrastructure and the seamless exchange of health data necessary for patient care and improved healthcare outcomes.

“Interoperability requires the ability to share clinical information across systems, networks and care providers. Barriers to data interoperability sit at the core of many process problems. We believe that better interoperability will unlock improvements in individual and population-level care coordination, delivery and management,” the companies said in a joint statement.

The renewed commitment comes in response to healthcare interoperability rules based on HL7 FHIR proposed by CMS and the Office of the National Coordinator for Health Information Technology (ONC).

One aspect of the ONC proposed rules deals with API developer certification. It requires developers to use the HL7 FHIR framework along with implementation specifications that provide technical requirements against which applications and other services can be built.

The ONC proposed rules require developers to ensure API access to and search capabilities for all data proposed as part of the U.S. Core Data for Interoperability for a single patient and multiple patients.

The rules also require developers to use secure connections that include authentication and authorization capabilities that enable patients to use an app to access their electronic health record without needing to log in each time they use the app.

“After the proposed rule takes effect, we commit to offering technical guidance based on our work including solution architecture diagrams, system narratives, and reference implementations to accelerate deployments for all industry stakeholders. We will work diligently to ensure these blueprints provide a clear and robust path to achieving the spirit of an API-first strategy for healthcare interoperability," the companies noted in the statement.

“As a technology community, we believe that a forward-thinking API strategy as outlined in the proposed rules will advance the ability for all organizations to build and deploy novel applications to the benefit of patients, care providers, and administrators alike,” they concluded.

FHIR Provides Next-Gen Healthcare Interoperability Framework

Created by HL7, FHIR is a next-generation standards framework for healthcare interoperability.

FHIR solutions are built from a set of modular components called "resources,” which can be assembled into working systems that solve clinical and administrative interoperability challenges. FHIR can be used in a variety of contexts, such as mobile phone apps, cloud communications, electronic health record data sharing, and server communication at large healthcare providers.

The cloud vendors noted that they have released a number of open-sourced tools based on the FHIR framework: Google’s FHIR protocol buffers and Apigee Health APIx, Microsoft’s FHIR Server for Azure, Cerner's FHIR integration for Apache Spark, a serverless reference architecture for FHIR APIs on Amazon Web Services, Salesforce/Mulesoft's Catalyst Accelerator for Healthcare templates, and IBM’s Apache Spark service.

In a blog post, Josh Mandel, chief architect for Microsoft Healthcare, said that his company is taking a “collaborative approach to building open tools that will help the healthcare community, including cloud-hosted APIs and services for AI [artificial intelligence] and machine learning. Microsoft understands that true interoperability in healthcare requires end-to end solutions, rather than independent pieces, which may not work together.”

Mandel added: “Transforming healthcare means working together with organizations across the ecosystem. Today’s joint interoperability statement reflects the feedback from our healthcare customers and partners, and together we will lay a technical foundation to support value-based care. We expect that the assumptions from our joint statement will continue to evolve and be refined based on this open dialog with the industry.”